36D2004478 CLIA NUMBER - OHIOHEALTH PHYSICIAN GROUP PRIMARY CARE ROCKFORD

Laboratory Demographics

  • CLIA Code: 36D2004478
  • Facility Name: OHIOHEALTH PHYSICIAN GROUP PRIMARY CARE ROCKFORD
  • Facility Address: 506 SOUTH MAIN STREET
    ROCKFORD, OH
    ZIP 45882
  • Facility Phone: 419 363-3008
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MORGAN HUNTER
  • NPI Number: 1053454314
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 36D2004478
LAB Type Physician Office
Facility Name OHIOHEALTH PHYSICIAN GROUP PRIMARY CARE ROCKFORD
Street 506 SOUTH MAIN STREET
City ROCKFORD
State OH
ZIP 45882
Phone 419 363-3008
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/5/2024
Certificate Expiration Date 3/4/2026
Facility Type Physician Office
Lab Director MORGAN HUNTER

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This page was last updated on: 9/29/2025